REGIONAL LEFT-VENTRICULAR WALL-MOTION ABNORMALITIES IN MYOCARDIAL-INFARCTION AND MITRAL ANNULAR DESCENT VELOCITIES STUDIED WITH PULSED TISSUE DOPPLER IMAGING

We evaluated global left ventricular (LV) systolic function from mitra l annular systolic motion velocities measured by pulsed tissue Doppler imaging in patients with previous myocardial infarction (MI) and LV r egional wall motion abnormalities. The subject group consisted of 45 p atients with wall asynergies, 3 with ischemic cardiomyopathy, 8 with d ilated cardiomyopathy, and 15 healthy control subjects, The peak systo lic descent velocity (Sw) and the time from the electrocardiographic Q wave to the peak of the systolic wave (Q-Sw) were measured at 6 mitra l annular sites obtained from 2-dimensional apical long-axis, 4-chambe r, and 2-chamber echocardiograms; these variables were compared with t he LV ejection fraction (EF) calculated from the left ventriculogram. The mean Sw at the sites corresponding to the infarct regions was sign ificantly lower and the mean Q-Sw was significantly longer in the MI g roups than in the control group. The mean Sw and Q-Sw at all 6 sites i n the ischemic and dilated cardiomyopathy groups were significantly lo wer and longer, respectively, than those of the control group. There w ere significant correlations between the EF and the means of the Sw an d Q-Sw values at the sites corresponding to the infarct regions in the MI groups. In the ischemic and dilated cardiomyopathy groups, signifi cant correlations existed between the EF and the means of the Sw and Q -Sw values at all 6 sites. Thus the parameters obtained from mitral an nular systolic motion velocities with pulsed tissue Doppler imaging re flect LV asynergy corresponding to the infarct regions in patients wit h MI, and global LV systolic function may be evaluated with these para meters.